A novel prognosis marker based on combined preoperative carcinoembryonic antigen and systemic inflammatory response for resectable gastric cancer

Ma, Yubin; Lin, Junpeng; Lin, Jianxian; Hou, Junfang; Xiao, Qin; Yu, Fang; Ma, Zhijun; Li, Ping; Tu, Ruhong; Xie, Jianwei; Zheng, Chaohui; Yan, Su; Huang, Changming

doi:10.7150/jca.52299

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International Journal of Biological Sciences

International Journal of Medical Sciences

Theranostics

Journal of Genomics

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J Cancer 2021; 12(3):927-935. doi:10.7150/jca.52299 This issue Cite

Research Paper

A novel prognosis marker based on combined preoperative carcinoembryonic antigen and systemic inflammatory response for resectable gastric cancer

Yubin Ma^1#, Junpeng Lin^2#, Jianxian Lin^2#, Junfang Hou¹, Qin Xiao¹, Fang Yu¹, Zhijun Ma¹, Ping Li², Ruhong Tu², Jianwei Xie², Chaohui Zheng², Su Yan^1✉, Changming Huang^2✉

1. Department of Gastrointestinal Oncology, Qinghai University Affiliated Hospital, Xining, People's Republic of China.
2. Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China.
#Co-first authors with equal contributions to this work.

✉ Corresponding authors: Changming Huang, M.D., Dept. of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou 350001, Fujian Province, People's Republic of China. Tel: +86 591 83363366, Fax: +591-83363366, E-mail: hcm More

Citation:

Ma Y, Lin J, Lin J, Hou J, Xiao Q, Yu F, Ma Z, Li P, Tu R, Xie J, Zheng C, Yan S, Huang C. A novel prognosis marker based on combined preoperative carcinoembryonic antigen and systemic inflammatory response for resectable gastric cancer. J Cancer 2021; 12(3):927-935. doi:10.7150/jca.52299. https://www.jcancer.org/v12p0927.htm

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Abstract

Background: Carcinoembryonic antigen (CEA) is one of the important indexes for the diagnosis and prognosis of gastrointestinal cancer. Systemic inflammatory response (SIR) is closely related to the occurrence and development of gastrointestinal cancer.

Methods: A total of 803 patients who underwent radical gastrectomy in Qinghai University Affiliated Hospital from January 2012 to December 2016 were included as training set. Multivariable Cox proportional hazard regression was used to identify associations with outcome of gastric cancer (GC). CNLR was established by combining CEA and the neutrophils to lymphocytes ratio (NLR, a typical parameter in SIR) to generate a novel prognostic score system and its prognostic value was externally validated.

Results: Multivariate analysis showed that CEA and NLR were independent prognostic factors for GC patients (both p < 0.05). A higher CNLR was significantly associated with older age, male sex, larger tumor size, vascular invasion and advanced stages (all p < 0.05). Patients with higher CNLR had poor prognosis than those with lower CNLR (p < 0.05). Multivariate analysis showed that CNLR was an independent prognostic factor (p < 0.05). Incorporation of the CNLR into a prognostic model including age and TNM stage generated a nomogram, which predicted accurately 3- and 5-year survival for GC patients. And similar results were obtained in the external validation set.

Conclusions: The CNLR prognostic scoring system established by combining CEA and NLR is an independent prognostic factor for GC, which can be incorporated into the traditional TNM staging to improve the prediction of long-term survival outcomes.

Keywords: gastric cancer, carcinoembryonic antigen, systemic inflammatory response, nomogram, prognosis

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APA

Ma, Y., Lin, J., Lin, J., Hou, J., Xiao, Q., Yu, F., Ma, Z., Li, P., Tu, R., Xie, J., Zheng, C., Yan, S., Huang, C. (2021). A novel prognosis marker based on combined preoperative carcinoembryonic antigen and systemic inflammatory response for resectable gastric cancer. Journal of Cancer, 12(3), 927-935. https://doi.org/10.7150/jca.52299.

ACS

Ma, Y.; Lin, J.; Lin, J.; Hou, J.; Xiao, Q.; Yu, F.; Ma, Z.; Li, P.; Tu, R.; Xie, J.; Zheng, C.; Yan, S.; Huang, C. A novel prognosis marker based on combined preoperative carcinoembryonic antigen and systemic inflammatory response for resectable gastric cancer. J. Cancer 2021, 12 (3), 927-935. DOI: 10.7150/jca.52299.

NLM

CSE

Ma Y, Lin J, Lin J, Hou J, Xiao Q, Yu F, Ma Z, Li P, Tu R, Xie J, Zheng C, Yan S, Huang C. 2021. A novel prognosis marker based on combined preoperative carcinoembryonic antigen and systemic inflammatory response for resectable gastric cancer. J Cancer. 12(3):927-935.

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